Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes

Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (beta hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood beta hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation rho = 0.364, p < 10(-4)). A weak positive relationship was found between blood glucose and breath acetone (rho = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.